By clicking on the Certify Checkbox
below, I certify that all information provided on this application
is true, accurate and complete. In addition, I understand that this
certifcation authorizes the Department of Fire & Rescue to investigate
my criminal and motor vehicle operation background to verify the
information in correct.
The information supplied by me in this application
is complete and is true to the best of my knowledge and belief.
I understand that misstatement of material facts will cause forfeiture
of all my rights to any employment or result in dismissal from employment.
In addition, I grant permission to the Virginia
Division of Motor Vehicles to provide copies of my driving record
to the Bedford County Department of Fire and Rescue for evaluation
All information provided to the Department of Fire
and Rescue will remain confidential and will not be released to
outside entities except as required by law.